What is Emergency Contraception (EC) and How Does it Work?

The Morning After pill scheduled into Calendar

70% of women between the ages of 15 and 44 are at risk of unintended pregnancy. Because the average woman only has 2 children in her life, she will have to spend almost 30 yrs of her life preventing pregnancy. When women fail to take birth control such as missing 3 days of the birth control pill, patch or ring in a row or not getting a depo-provera shot on time, emergency contraception (EC) can come to the rescue by preventing an egg from being released and/or fertilized and preventing implantation in the uterus.

How long out can emergency contraception be used?

The “morning after pill” is a misnomer because it can be used for up to 5 days after a contraceptive failure or sexual assault. However, it is recommended that you take it ASAP, because for most methods, after the egg comes out (ovulation) then the methods don’t work as well.

When would a woman need emergency contraception (EC)?

-The condom broke during sex 4 days ago

-I forgot the last 3 days of oral contraceptive pills and had sex today

-I went to the bathroom after sex and my NuvaRing® fell out into the toilet, and I couldn’t get another NuvaRing for 3 days.

-I just realized I forgot to get my Depo-provera shot and had sex last night

-I was date-raped 4 days ago

What can you do if you are worried that your birth control method has failed, you didn’t use contraception, or you were forced to have sex against your will?

If any of those situations happen, women still have options to prevent pregnancy. There are 4 types of emergency contraception, and they prevent ovulation,fertilization and implantation. Here they are from MOST effective to LEAST effective:

#1 Copper IUD

The most effective emergency contraception is the copper IUD. It is 99.999999999% effective as an emergency contraceptive method. However, this requires a visit to a doctor’s office or Emergency Room and it requires a doctor/nurse practitioner to put it in. The good news is that a woman can then use the copper IUD for long term contraception for up to 10-12 years after. However, the 2 major side effects of the copper IUD as a long term contraception is more bleeding with periods and more painful periods.

#2 Ella® = ulipristal acetate = a Prescription pill that is MORE effective than the over-the-counter pill.

The 2nd most effective EC is Ella® or ulipristal acetate. It is more effective at preventing pregnancy at every time point than Plan B® and its generics. Under the Affordable Care Act, it should be available under most insurances for “free” = with no copay, no deductible. You have to get a doctor’s prescription though. (All customers of Pandia Health’s telemedicine service are offered a prescription for EC at NO extra charge so they are covered in case of an emergency.) If your BMI> 35, then you should consider the copper IUD for EC.

#3 Plan B® and its generics a.k.a. Levonorgestrel, the over-the-counter emergency contraception pill.

The 3rd most effective EC is Plan B® and its generics can be purchased over-the-counter at most pharmacies, drug stores, or health clinics. Men and women do not have to prove their age nor show I.D. to buy levonorgestrel emergency contraceptives over-the-counter. However, if your BMI is 26 or greater, Plan B and its generics are NOT effective. Read here.

#4 Yuzpe Method

Lastly, there’s the Yuzpe method where you need to get 100mcg of ethinyl estradiol and 1mg of norgestrel now and again in 12 hours. This has HALF the efficacy of Plan B® and its generics and TWICE the side effects. But if you are in the middle of nowhere and only have a pack of pills, this is your best bet. You can look up on the internet exactly what pills you have and how many of which color/row you need to take to get to the recommended dose.

Dr. Yen (Pandia Health’s CEO and Co-Founder) suggests that “All hetero-sexually active men and women of any orientation keep emergency contraceptives on-hand in case of an accident. The longer you wait after unprotected sex or a birth control failure, the less likely the pill versions of emergency contraception will work. The copper IUD has the same efficacy throughout the 5 days.

 

 

Is emergency contraception the same as the “abortion pill”?

No. Emergency contraceptive pills mainly work by preventing an egg from being fertilized. If you are pregnant and you take the emergency contraception pills, NOTHING will happen. The abortion pill, also known as RU486 or mifepristone, is a prescription medication that is given to women within the first 10 weeks of pregnancy to induce a miscarriage a.k.a. abortion and requires often an ultrasound as well.

How do emergency contraceptives work?

Emergency contraceptives are often referred to as “morning-after pills.” However, women can also have a copper IUD inserted as an emergency contraceptive. For the pills, the sooner a woman uses an emergency contraceptive, the more effective it will be to prevent pregnancy.

The Copper IUD prevents sperm from fertilizing an egg.

EC pills work by delaying or blocking ovulation (when the egg pops out).

Over-the-counter emergency contraceptives are most effective if taken within the first 72 hours, or 3 days, after a birth control failure. All EC pills (prescription and over the counter) CAN work up to 5 days, but Dr. Yen (our CEO and Co-Founder) says “If the condom pops at 3 a.m., we want EC in the woman’s mouth by 3:10 am. No cuddling, huddling, waiting until ‘the morning after’ because once the egg pops out, the EC won’t work.”

Are there any side effects to using emergency contraceptives?

Emergency contraceptive pill side effects include: nausea, breakthrough bleeding, and menstrual cycle arriving late or early.

After placement, copper IUDs can cause cramping, breakthrough bleeding, and heavier or longer periods.

Emergency contraceptives do NOT cause congenital defects, do not cause infertility, nor do they protect against sexually transmitted infections (STIs). Emergency contraceptives are also not as effective as birth control used before or during sex (condoms). For maximum protection against STIs and unintended pregnancy, couples need to use hormonal birth control methods before sex and male or female condoms during sex.

Emergency contraceptive pills should be just that, an emergency, and not used in place of a regular birth control method. Regular birth control – such as the IUD with hormone, implant, shot, ring, patch, pill are all more effective than emergency contraception.

Pandia Health offers “free” and low-cost emergency contraceptives, birth control pills, patches, and rings to women with and without insurance coverage. If you’re interested in fully protecting yourself from an unintended pregnancy, the doctors and Patient Care Advisors at Pandia Health are happy to assist you with your birth control needs. Please contact them today to explore your options for having birth control delivered straight to your door.

updated: 8.13.19 sy